EP2740420B1 - Treatment tool - Google Patents
Treatment tool Download PDFInfo
- Publication number
- EP2740420B1 EP2740420B1 EP12822837.6A EP12822837A EP2740420B1 EP 2740420 B1 EP2740420 B1 EP 2740420B1 EP 12822837 A EP12822837 A EP 12822837A EP 2740420 B1 EP2740420 B1 EP 2740420B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- driving
- rotational center
- manipulation
- state
- manipulation member
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- 230000005540 biological transmission Effects 0.000 claims description 44
- 238000003780 insertion Methods 0.000 description 19
- 230000037431 insertion Effects 0.000 description 19
- 230000000694 effects Effects 0.000 description 4
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 230000008602 contraction Effects 0.000 description 2
- 230000001419 dependent effect Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2913—Handles transmission of forces to actuating rod or piston cams or guiding means
- A61B2017/2916—Handles transmission of forces to actuating rod or piston cams or guiding means pins in guiding slots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2925—Pistol grips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2936—Pins in guiding slots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2944—Translation of jaw members
Definitions
- the present invention relates to a treatment tool.
- a treatment tool used with a flexible endoscope is configured to transmit a driving force from a manipulation unit to a treatment unit by a wire, a coil, or the like. Since the wire or the coil may be expanded or contracted by the driving force, such a treatment tool has a configuration of moving the wire or the coil to an extent larger than a necessary minimum movement amount corresponding to a movable range of the treatment unit.
- Patent Document 1 discloses a configuration of a manipulation unit configured to rotate a driving manipulation member (a movable handle) about a predetermined rotate point as a rotational center and move a manipulation rod by a driving manipulation member, which is rotated.
- a driving manipulation member a movable handle
- Patent Document 2 discloses a treatment tool according to the preamble of claim 1.
- the conventional treatment tool In the conventional treatment tool, a relation of a moving speed of the treatment unit to a moving speed of the driving manipulation unit or a relation between a force applied to the driving manipulation member by an operator and a force of operating the treatment unit keeps definite relation. For this reason, the conventional treatment tool is impossible to adapt a case that is preferable to apply a large force to the target or to move the treatment unit rapidly.
- a treatment tool may include a long shaft member having a distal end portion and a proximal end portion; a treatment unit installed at the distal end portion of the long shaft member and configured to be capable of being operated between a first position and a second position for treating a target area; a driving force transmission member connected to the treatment unit and extending along the longitudinal axis so as to be freely moved along the longitudinal axis with respect to the long shaft member so that the treatment unit is operated between the first position and the second position; a manipulation unit configured to be capable of being manipulated so that the driving force transmission member moves with respect to the long shaft member; and a switch unit allowing the treatment unit to be operated between the first position and the second position and switch a ratio of a movement amount of the driving force transmission member with respect to a manipulation amount of the manipulation unit, in accordance with a manipulation amount of the manipulation unit.
- the above described treatment unit may have a pair of jaws connected to the driving force transmission member and may be configured to be opened by a force transmitted via the driving force transmission member.
- the first position may be a position at which the pair of jaws are opened from each other, and the second position may be a position at which the pair of jaws are closed to each other.
- the treatment unit may include a manipulation unit main body installed at the proximal end portion of the long shaft member, and a driving manipulation member connected to the driving force transmission member and configured to be capable of moving with respect to the manipulation unit main body.
- the switch unit may allow the treatment unit to be operated between the first position and the second position and may switch a ratio of a movement amount of the driving force transmission member with respect to a manipulation amount of the driving manipulation member with respect to the manipulation unit main body, in accordance with a manipulation amount of the driving manipulation member with respect to the manipulation unit main body.
- the switch unit may include a rotational center switch unit configured to switch a moving state of the driving manipulation member with respect to the manipulation unit main body into a moving state of any one of a first state in which the driving manipulation member is rotated about a first rotational center with respect to the manipulation unit main body and a second state in which the driving manipulation member is rotated about a second rotational center different from the first rotational center with respect to the manipulation unit main body.
- the driving manipulation member may move from a start position to an end position or from the end position to the start position substantially in one direction with respect to the manipulation unit main body
- the rotational center switch unit may switch a rotational center of the driving manipulation member with respect to the manipulation unit main body from the first rotational center to the second rotational center or from the second rotational center to the first rotational center at at least one location between the start position and the end position.
- a magnitude of a force applied to the driving manipulation member is set as F in
- a magnitude of a force of driving the driving force transmission member via the switch unit is set as F out
- a distance between an input section and the first rotational center when a predetermined point at which a force is applied to the driving manipulation member to manipulate the driving manipulation member is designated as the input section is set as L 1
- a distance between a connecting position of the driving force transmission member to the driving manipulation member and the first rotational center is set as L 2
- a distance between the input section and the second rotational center is set as L 3
- a distance between the connecting position and the second rotational center is set as L 4
- L 1 /L 2 ⁇ L 3 /L 4 .
- the treatment tool it is possible to appropriately grip the target by merely moving the driving manipulation member by the treatment tool in substantially one direction between the first position and the second position.
- FIG. 1 is a side view of the treatment tool according to the first embodiment of the present invention.
- FIG 2 is a side view showing a handle mechanism installed at the treatment tool.
- FIG. 3 is a perspective view showing a portion of a driving manipulation member installed at the handle mechanism.
- FIG. 4 is a schematic view showing an operational principle of the handle mechanism.
- the treatment tool 1 includes a long insertion section (a long shaft member) 2, a treatment unit 3, a manipulation unit 6, and a driving force transmission member 30.
- the treatment unit 3 is installed at a distal end (a distal end portion) 2a of the insertion section 2.
- the manipulation unit 6 is installed at a proximal end (a proximal end portion) 2b of the insertion section 2 to manipulate the treatment unit 3.
- the driving force transmission member 30 is connected to the manipulation unit 6 and the treatment unit 3.
- the insertion section 2 is a tubular member having flexibility, into which the driving force transmission member 30 is inserted so as to advance and retract along a longitudinal axis 2c of the insertion section 2.
- the insertion section 2 is constituted by a coil sheath on which a flexible wire rod is wound.
- the insertion section 2 constituted by the coil sheath has a high tolerance with respect to compression of the insertion section 2 in a central axis direction.
- the insertion section 2 can transmit a rotational force when a proximal end of the insertion section 2 is rotated about a central axis as a rotational force for rotating a distal end of the insertion section 2 about the central axis.
- the treatment unit 3 has a pair of jaws 4 opened and closed by linear movement of the driving force transmission member 30 in the central axis direction of the insertion section 2.
- the jaws 4 are connected to a distal end of the driving force transmission member 30 via a known link mechanism 5.
- a force transmitted via the driving force transmission member 30 is converted into a force for opening/closing the jaws 4 by the link mechanism 5.
- the pair of jaws 4 are open (a first position)
- the pair of jaws 4 are closed (a second position).
- the treatment unit 3 may include, instead of the pair of jaws 4 that can be opened and closed, such as other forceps, a stapler, a clip, a needle holder, and the like.
- the link mechanism 5 is configured to convert a linear movement of the driving force transmission member 30 into an operation of the treatment unit 3.
- the manipulation unit 6 includes an exterior body (a manipulation unit main body) 7 connected to the proximal end of the insertion section 2, and a handle mechanism 10 partially installed in the exterior body 7.
- a grip 8 held by an operator to manipulate a driving manipulation member 11 is formed at the exterior body 7.
- the grip 8 is a rod-shaped member extending in substantially the same direction as a direction in which the driving manipulation member 11 protrudes from the exterior body 7.
- the handle mechanism 10 includes the driving manipulation member 11, and a switch unit 20.
- the driving manipulation member 11 is configured to be connected to the proximal end of the driving force transmission member 30 in the exterior body 7 and protrude to the outside of the exterior body 7.
- the switch unit 20 is installed in the exterior body 7 and connected to the driving manipulation member 11 in the exterior body 7.
- the driving manipulation member 11 includes a trigger section 12 on which an operator's finger is set, and a connecting section 14 connected to the switch unit 20.
- a leverage point P6 based on design is previously determined on the input section 13.
- the switch unit 20 is designed on the assumption that the operator applies a force to the leverage point P6 based on design.
- the driving manipulation member 11 is moved with respect to the exterior body 7 of the manipulation unit 6 by the operator's finger put on the trigger section 12.
- the connecting section 14 has a first pin 15 and a second pin 16 disposed in the exterior body 7.
- the first pin 15 and the second pin 16 are substantially columnar shaped members having central axes O1 and O2 parallel to each other.
- bearings 18 rotatable about the central axes O1 and O2 as rotational centers are inserted into the first pin 15 and the second pin 16.
- the bearings 18 have outer circumferential surfaces formed columnar and are rotated about the rotational center upon contact with slide rails 22 (to be described later).
- the switch unit 20 is installed at the manipulation unit 6 in an attempt to get the treatment unit 3 to be operated between the first position and the second position and to switch a ratio of a movement amount of the driving force transmission member 30 with respect to a movement amount of the driving manipulation member 11.
- the switch unit 20 has a base 21 disposed in the manipulation unit 6 and fixed to the manipulation unit 6, and the slide rails 22 installed at the base 21.
- the slide rails 22 formed at the base 21 include a first slide rail 23 and a second slide rail 24.
- the first slide rail 23 is a linear slide rail extending to be parallel to a direction in which the insertion section 2 protrudes from the manipulation unit 6.
- the second slide rail 24 is a slide rail formed at a position spaced apart from the first slide rail 23.
- the first slide rail 23 is a groove or a through-hole formed in the base 21.
- a pair of inner surfaces extending in a longitudinal direction of the first slide rail 23 is parallel to each other.
- a distance between the pair of inner surfaces is slightly larger than an outer dimension of the bearing 18 attached to the first pin 15.
- the second slide rail 24 is configured by a groove or a through-hole formed in the base 21.
- the second slide rail 24 has a linear section 25 parallel to the first slide rail 23, and an arc-shaped section 26 connected to the linear section 25.
- the second pin 16 to which the bearing 18 is attached is inserted into the linear section 25 and the arc-shaped section 26, and an outer circumferential surface of the bearing 18 attached to the second pin 16 comes in contact with an inner surface of the linear section 25 or the arc-shaped section 26.
- the arc-shaped section 26 is formed in an arc shape centered on an end section of the proximal end side of the first slide rail 23. Specifically, a position of a central axis of the first pin 15 when the bearing 18 of the first pin 15 abuts the end section of the proximal end side of the first slide rail 23 is positioned at a center of an arc portion of the arc-shaped section 26.
- An end section of the arc-shaped section 26 opposite to a side thereof connected to the linear section 25 has a semi-circular shape conforming to a shape of the outer circumferential surface of the bearing 18.
- a distance between the first slide rail 23 and the second slide rail 24 is substantially equal to a distance between the first pin 15 and the second pin 16.
- the driving manipulation member 11 into which the second pin 16 and the first pin 15 are inserted is supported in the linear section 25 of the second slide rail 24 and the first slide rail 23 such that the driving manipulation member 11 can be linearly moved.
- the driving manipulation member 11 is supported in the arc-shaped section 26 of the second slide rail 24 and the first slide rail 23.
- the driving manipulation member 11 is supported by the slide rail such that the second pin 16 can be pivoted along the arc-shaped section 26 about the central axis of the first pin 15.
- the pair of jaws 4 are completely open. In the embodiment, this position is referred to as "a start position.”
- the driving manipulation member 11 is moved with respect to the manipulation unit 6 in substantially one direction between the start position and the end position.
- the second slide rail 24 of the slide rails 22 has a shape in which the linear section 25 and the arc-shaped section 26 are formed continuously each other. For this reason, a moving direction in which the driving manipulation member 11 is moved along the linear section 25 and a direction in which the driving manipulation member 11 is moved along the arc-shaped section 26 are not one direction in the strict sense.
- "the approximately one direction” includes the case in which the moving direction is varied such that the moving direction of the driving manipulation member 11 is not reversed when the driving manipulation member 11 is moved from the start position to the end position or when the driving manipulation member 11 is moved from the end position to the start position.
- a rotational center switch unit configured to switch a rotational center of the driving manipulation member 11 is constituted by the first pin 15 and the second pin 16 which are formed at the driving manipulation member 11, and the first slide rail 23 and the second slide rail 24 which are formed at the base 21.
- the first slide rail 23 is formed linearly
- the linear section 25 of the second slide rail 24 is formed linearly in parallel with the first slide rail 23.
- the driving manipulation member 11 in a state in which the first pin 15 is inserted into the first slide rail 23 and the second pin 16 is inserted into the linear section 25 may be said to be rotated about an imaginary rotational center disposed at a position spaced an infinite distance from the first slide rail 23.
- the imaginary rotational center is referred to as a first rotational center R1
- a position of the central axis of the first pin 15 when the first pin 15 is disposed at the end section of the proximal end side of the first slide rail 23 is referred to as a second rotational center R2.
- a state in which the driving manipulation member 11 is rotated about the first rotational center R1 is referred to as a first state
- a state in which the driving manipulation member 11 is rotated about the second rotational center R2 is referred to as a second state.
- the rotational center switch unit switches a rotational center of the driving manipulation member 11 with respect to the manipulation unit 6 from the first rotational center R1 to the second rotational center R2 or from the second rotational center R2 to the first rotational center R1 at a position between the start position and the end position, and at a boundary between the linear section 25 and the arc-shaped section 26. That is, the first state and the second state are switched by the rotational center switch unit.
- the driving force transmission member 30 is formed of a wire rod having flexibility and high strength against compression or tension in the central axis direction.
- the driving force transmission member 30 is pulled by the driving manipulation member 11, and transmits a force needed to drive the treatment unit 3 from the manipulation unit 6 to the treatment unit 3.
- the handle mechanism 10 is designed on the assumption that a force is applied from the operator to the leverage point P6 based on design of the input section 13.
- a magnitude of a force applied to the driving manipulation member 11 by the operator is set as F in .
- a magnitude of a force driven by the driving force transmission member 30 via the switch unit 20 is set as F out .
- a distance between the leverage point P6 of the input section 13 and the first rotational center R1 is set as L 1 .
- a distance between a connecting position at which the driving force transmission member 30 is connected to the driving manipulation member 11 and the first rotational center R1 is set as L 2 .
- a distance between the leverage point P6 of the input section 13 and the second rotational center R2 is set as L 3 .
- a distance between the connecting position and the second rotational center R2 is set as L 4 .
- the relational expression of them is L 1 /L 2 ⁇ L 3 /L 4 . That is, in the second state, in comparison with the first state, a force applied to the driving force transmission member 30 is larger than a force input to the input section 13. This is because the input to the input section 13 is reduced to be transmitted to the driving force transmission member 30 according to the principle of leverage.
- the treatment tool 1 When using the treatment tool 1, for example, the treatment tool 1 is set in a treatment tool channel of a flexible endoscope (not shown), and guides the treatment unit 3 to a treatment target.
- a flexible endoscope not shown
- the operator of the treatment tool 1 grips the grip 8 of the manipulation unit 6, puts his/her finger on the driving manipulation member 11 protruding from the exterior body 7, and moves the driving manipulation member 11 with respect to the manipulation unit 6 in a desired direction.
- the driving manipulation member 11 is moved from the start position to the end position, the driving force transmission member 30 is moved in a direction from the distal end of the insertion section 2 toward the proximal end by the force moving the driving manipulation member 11, and the pair of jaws 4 are changed from a completely open state (a first position) to a completely closed state (a second position).
- the second pin 16 When the pair of jaws 4 are in the completely closed state, the second pin 16 is disposed slightly closer to the distal end side than the end section of the proximal end side of the arc-shaped section 26. For this reason, when the driving manipulation member 11 is further moved until the bearing 18 of the second pin 16 comes in contact with the end section of the proximal end side of the arc-shaped section 26, a force in a closing direction of the pair of jaws 4 can be applied to the pair of jaws 4 in the completely closed state. Accordingly, the pair of jaws 4 can be securely closed even when expansion and contraction of the insertion section 2 or expansion and contraction of the driving force transmission member 30 occur.
- the moving state of the driving manipulation member 11 with respect to the manipulation unit 6 is switched from the first state to the second state by the switch unit 20.
- the moving state of the driving manipulation member 11 with respect to the manipulation unit 6 is switched from the first state in which the driving manipulation member 11 is rotated with respect to the manipulation unit 6 about the first rotational center R1 to the second state in which the driving manipulation member 11 is rotated with respect to the manipulation unit 6 about the second rotational center R2 different from the first rotational center R1.
- a movement amount of the driving manipulation member 11 is equal to a movement amount of the driving force transmission member 30.
- the movement amount of the driving force transmission member 30 is smaller than that of the driving manipulation member 11.
- the movement amount of the driving force transmission member 30 is reduced with respect to the movement amount of the driving manipulation member 11 and a force applied to the treatment unit 3 is increased accordingly.
- the gripping target can be gripped by the pair of jaws 4 with a force larger than that of the first state.
- the pair of jaws 4 can be rapidly moved in a state in which the gripping target is not separately gripped.
- the conventional handle mechanism das not have a mechanism for varying a reduction ratio between the first state and the second state, even when a range in which a large force needs to be applied and a range in which rapid movement is preferable are provided, the moving speed of the treatment unit with respect to the moving speed of the driving manipulation member or the force applied to the driving manipulation member by the operator and the force of operating the treatment unit are not varied from a constant relation.
- each of the jaws 4 can be rapidly moved in the first state at a position near the position where a position in the state that the pair of jaws 4 are completely opened within the movable range in which the pair of jaws 4 are opened and closed, and a larger force than that of the first state can be applied to the pair of jaws 4 in the second state at a position near the position where a position in a state that the pair of jaws 4 are completely closed within the movable range in which the pair of jaws 4 are opened and closed.
- the gripping target having elasticity such as a biological tissue or the like may be grasped using the pair of jaws 4 by closing the pair of jaws 4.
- the gripping target can be appropriately grasped by only moving the driving manipulation member 11 substantially in one direction within a state that the pair of jaws 4 are positioned from the completely open state to the completely closed state.
- the movable range of the driving manipulation member 11 with respect to the manipulation unit 6 is preferably within a range in which the driving manipulation member 11 can be moved by the operator opens or closes his/her hand. For this reason, the movable range of the driving manipulation member 11 has an upper limit.
- the movement amount of moving the driving manipulation member 11 can be set to be large in the second state. For this reason, even in a state in which the movable range of the driving manipulation member 11 is limited, the opening/closing movement amount of the pair of jaws 4 can be sufficiently secured and a force having a sufficient magnitude with respect to the pair of jaws 4 can be applied.
- the driving manipulation member 11 is actually moved linearly because the first rotational center R1 is disposed at a position of an infinite distance. For this reason, the driving manipulation member 11 is moved linearly in the first state and rotated in the second state, and movement of the driving manipulation member 11 is remarkably changed at a position at which the first state and the second state are switched. As a result, the operator who manipulates the treatment tool 1 can easily recognize whether the handle mechanism 10 is in the first state or the second state.
- FIG 5 is a side view showing a handle mechanism of the modified example.
- the modified example is different from the above-mentioned first embodiment in that the handle mechanism 10 is reversely disposed back and forth. That is, the arc-shaped section 26 of the second slide rail 24 is disposed at the distal end side of the manipulation unit 6.
- the driving manipulation member 11 has a shape so as to easily hook a finger while the driving manipulation member 11 is pushed toward the distal end. Specifically, a ring portion through which a finger can pass is formed at the driving manipulation member 11.
- the driving manipulation member 11 is moved from the distal end side to the proximal end side of the manipulation unit 6, when the position of the second pin 16 is switched from the arc-shaped section 26 to the linear section 25 of the second slide rail 24, a magnitude of force required for the operator to manipulate the driving manipulation member 11 is increased. Accordingly, the operator can recognize that the operator has been operated a given amount of work for which the driving manipulation member 11 is moved to reach the proximal end through a feeling of the finger in contact with the driving manipulation member 11.
- the operator can recognize that the operator has gripped the driving manipulation member 11 with a given amount of distance. That is, the operator can recognize that the grasping forceps is closed until a predetermined position. Accordingly, it is possible to suppress to grasp the biological tissue or the like with an excessively strong force by the grasping forceps.
- FIG 6 is a side view showing a handle mechanism of the modified example.
- the modified example is different from the above-mentioned first embodiment in that a radius of the arc-shaped section 26 is larger than that of the arc-shaped section 26 of the first embodiment.
- the linear section 25 of the second slide rail 24 is offset closer to the distal end side than the linear section 25 described in the first embodiment.
- FIG. 7 is a side view showing a handle mechanism of the modified example.
- the modified example is different from the first embodiment in that the arc-shaped section 26 is formed at the first slide rail 23. That is, in the case of the modified example, the second pin 16 is supported at the end section of the proximal end side of the linear section 25 of the second slide rail 24. Then, a position of the central axis of the second pin 16 is a rotary shaft corresponding to the second rotational center R2 described in the above-mentioned first embodiment.
- the handle mechanism 10 can be miniaturized compared to the first embodiment.
- FIG 8 is a side view showing a handle mechanism according to the embodiment.
- the handle mechanism 10A includes a driving manipulation member 11A instead of the driving manipulation member 11, and a switch unit 20A instead of the switch unit 20.
- the driving manipulation member 11 A further includes a third pin 17 in addition to the first pin 15 and the second pin 16.
- the first pin 15, the second pin 16 and the third pin 17 are disposed in parallel on a straight line.
- the above-mentioned bearing 18 (see FIG. 3 ) is attached to the third pin 17.
- the switch unit 20A includes a first slide rail 23A, a second slide rail 24A and a third slide rail 27A.
- the first slide rail 23A is formed in an arc shape about a first rotational center R1A set at a position different from the first rotational center R1.
- the second slide rail 24A and the third slide rail 27A are formed apart from the first slide rail 23A.
- the second slide rail 24A includes a first arc-shaped section 25A and a second arc-shaped section 26A.
- the first arc-shaped section 25A is concentrically formed with the first slide rail 23A, and formed in an arc shape parallel to the first slide rail 23A.
- the second arc-shaped section 26A is formed in an arc shape having a larger radius of curvature than that of the first arc-shaped section 25A.
- the third slide rail 27A is formed in an arc shape concentric with the second arc-shaped section 26A.
- the end section of the proximal end side of the third slide rail 27A is disposed on a straight line passing through a boundary between the first arc-shaped section 25A and the second arc-shaped section 26A, and the end section of the proximal end side of the first slide rail 23A.
- the end section of the distal end side of the third slide rail 27A is disposed on a straight line passing through the end section of the proximal end side of the second arc-shaped section 26A and the end section of the proximal end side of the first slide rail 23A.
- a state in which the second pin 16 is moved along the first arc-shaped section 25A is a first state in which the driving manipulation member 11 A is moved about the first rotational center R1A.
- a state in which the second pin 16 is moved along the second arc-shaped section 26A is a second state in which the driving manipulation member 11 A is moved about the second rotational center R2A.
- a relational expression is L 1 /L 2 ⁇ L 3 /L 4 .
- a center of the arc of the third slide rail 27A is the above-mentioned second rotational center R2A, and the third pin 17 is fixed to the end section of the proximal end side of the third slide rail 27A until the first pin 15 is moved to the end section of the proximal end side of the first slide rail 23A.
- the second pin 16 When the driving manipulation member 11 A is moved until the first pin 15 comes in contact with the end section of the proximal end side of the first slide rail 23A, the second pin 16 is positioned at a boundary between the first arc-shaped section 25A and the second arc-shaped section 26A. After that, when the driving manipulation member 11 A is further moved, the second pin 16 is moved toward the proximal end of the second arc-shaped section 26A.
- the third slide rail 27A is formed in an arc shape having the same rotational center as the second arc-shaped section 26A, the driving manipulation member 11 A is rotated about a position of the central axis of the first pin 15 in contact with the end section of the proximal end side of the first slide rail 23A as a rotational center.
- first pin 15, the second pin 16 and the third pin 17 may not be disposed in parallel on the same straight line.
- FIG. 9 is a side view showing a handle mechanism of the modified example.
- a fourth slide rail 28 branched off from the proximal end of the first slide rail 23A, formed in an arc shape about the proximal end of the second arc-shaped section 26A and extending toward the distal end side is provided with the first slide rail 23A.
- a third arc-shaped section 29 positioned closer to the distal end side than the distal end of the third slide rail 27A described in the second embodiment and formed in an arc shape having the same rotational center as the fourth slide rail 28 is formed at the third slide rail 27A.
- the driving manipulation member 11A when the driving manipulation member 11A is further moved toward the proximal end from a state in which the second pin 16 is positioned at the end section of the proximal end side of the second arc-shaped section 26A, the driving manipulation member 11A is rotated about a position of the central axis of the second pin 16 as a rotational center.
- a position of the central axis of the second pin 16 in a state in which the second pin 16 is positioned at the end section of the proximal end side of the second arc-shaped section 26A is a third rotational center R3 configured to transmit a force to the driving force transmission member 30 from the driving manipulation member 11A at a reduction ratio different from the first state and second state.
- a state in which the driving manipulation member 11 is rotated about the third rotational center R3 is referred to as "a third state.”
- the first state in which the driving manipulation member 11 is rotated about the first rotational center R1A, the second state in which the driving manipulation member 11 is rotated about the second rotational center R2A, and the third state in which the driving manipulation member 11 is rotated about the third rotational center R3 are sequentially switched. Accordingly, the magnitude of the force applied to the treatment unit 3 including the pair of jaws 4 or the like can be switched in three stages.
- the switching of the magnitude of the force applied to the treatment unit 3 may be performed in more than three stages.
- FIG 10 is a side view showing a handle mechanism 10B.
- the handle mechanism 10B is different from the first embodiment in that the driving manipulation member 11 is moved linearly in both of the first state and the second state described in the above-mentioned first embodiment.
- the first slide rail 23 has a linear section 23B formed at a distal end side of the manipulation unit 6 and a second linear section 23C formed at a proximal end side of the manipulation unit 6, and the second slide rail 24 has a linear section 25B formed at the distal end side of the manipulation unit 6 and a second linear section 25C formed at the proximal end side of the manipulation unit 6.
- the second linear sections 23C and 25C are inclined with respect to the linear sections 23B and 25B by an angle ⁇ , respectively. That is, the first slide rail 23 and the second slide rail 24 are formed in parallel between the distal end side and the proximal end side of the manipulation unit 6.
- a pulley 31 having an outer surface in contact with the driving force transmission member 30 is fixed to the manipulation unit 6.
- the pulley 31 is disposed near a boundary portion between the linear section 25B and the second linear section 25C.
- the driving manipulation member 11 When the driving manipulation member 11 is moved from the distal end to the proximal end of the manipulation unit 6, first, the driving manipulation member 11 is moved linearly along the linear sections 23B and 25B of the first slide rail 23 and the second slide rail 24. Then, the first pin 15 and the second pin 16 installed at the driving manipulation member 11 are moved to the second linear sections 23C and 25C from the linear sections 23B and 25B. Then, the moving direction of the driving manipulation member 11 is varied by the angle ⁇ .
- the driving force transmission member 30 when the proximal end of the driving force transmission member 30 is moved closer to the proximal end side of the manipulation unit 6 than the pulley 31, the driving force transmission member 30 comes in contact with the outer surface of the pulley 31.
- the driving force transmission member 30 in contact with the outer surface of the pulley 31 is in a state bent by the pulley 31 to the angle ⁇ .
- the driving force transmission member 30 is pulled in a state in which a reduction ratio is reduced to arrive at 1:(1/cos ⁇ ) with respect to the linear sections.
- the handle mechanism 10B when the operator grips the handle mechanism 10B until quantity of movement of the handle mechanism 10B becomes a given amount, the handle mechanism 10B is switched to a low reduction ratio.
- the operator since a magnitude of force required for the operator to operate the handle is increased, the operator can instinctively recognize that the operator has operated the handle until quantity of movement of the handle mechanism 10B becomes a given amount.
- the second linear sections may be disposed at the distal end side of the manipulation unit 6.
- a manipulation feeling is varied to be lighter.
- a configuration in which a first state is a state in which the driving manipulation member is rotated and a second state is a state in which the driving manipulation member is moved linearly can be used.
- the treatment tool can appropriately grip the target to be gripped by merely moving the driving manipulation member by the treatment tool in substantially one direction between the first position and the second position.
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Description
- The present invention relates to a treatment tool.
- In the related art, a treatment tool used with a flexible endoscope is configured to transmit a driving force from a manipulation unit to a treatment unit by a wire, a coil, or the like. Since the wire or the coil may be expanded or contracted by the driving force, such a treatment tool has a configuration of moving the wire or the coil to an extent larger than a necessary minimum movement amount corresponding to a movable range of the treatment unit.
- Patent Document 1 discloses a configuration of a manipulation unit configured to rotate a driving manipulation member (a movable handle) about a predetermined rotate point as a rotational center and move a manipulation rod by a driving manipulation member, which is rotated.
- Patent Document 2 discloses a treatment tool according to the preamble of claim 1.
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- Patent Document 1: Japanese Unexamined Patent Application, First Publication No.
H06-296618 - Patent Document 2:
EP 0 732 078 A2 - In the conventional treatment tool, a relation of a moving speed of the treatment unit to a moving speed of the driving manipulation unit or a relation between a force applied to the driving manipulation member by an operator and a force of operating the treatment unit keeps definite relation. For this reason, the conventional treatment tool is impossible to adapt a case that is preferable to apply a large force to the target or to move the treatment unit rapidly.
- It is an object of the present invention to provide a treatment tool capable of appropriately gripping a target to be gripped.
- A treatment tool according to the present invention is provided with the features of claim 1. Preferable embodiments are set-forth in the dependent claims.
A treatment tool may include a long shaft member having a distal end portion and a proximal end portion; a treatment unit installed at the distal end portion of the long shaft member and configured to be capable of being operated between a first position and a second position for treating a target area; a driving force transmission member connected to the treatment unit and extending along the longitudinal axis so as to be freely moved along the longitudinal axis with respect to the long shaft member so that the treatment unit is operated between the first position and the second position; a manipulation unit configured to be capable of being manipulated so that the driving force transmission member moves with respect to the long shaft member; and a switch unit allowing the treatment unit to be operated between the first position and the second position and switch a ratio of a movement amount of the driving force transmission member with respect to a manipulation amount of the manipulation unit, in accordance with a manipulation amount of the manipulation unit. - The above described treatment unit may have a pair of jaws connected to the driving force transmission member and may be configured to be opened by a force transmitted via the driving force transmission member. The first position may be a position at which the pair of jaws are opened from each other, and the second position may be a position at which the pair of jaws are closed to each other. In the above described treatment tool according to the second aspect, the treatment unit may include a manipulation unit main body installed at the proximal end portion of the long shaft member, and a driving manipulation member connected to the driving force transmission member and configured to be capable of moving with respect to the manipulation unit main body. The switch unit may allow the treatment unit to be operated between the first position and the second position and may switch a ratio of a movement amount of the driving force transmission member with respect to a manipulation amount of the driving manipulation member with respect to the manipulation unit main body, in accordance with a manipulation amount of the driving manipulation member with respect to the manipulation unit main body. The switch unit may include a rotational center switch unit configured to switch a moving state of the driving manipulation member with respect to the manipulation unit main body into a moving state of any one of a first state in which the driving manipulation member is rotated about a first rotational center with respect to the manipulation unit main body and a second state in which the driving manipulation member is rotated about a second rotational center different from the first rotational center with respect to the manipulation unit main body.
In the above described treatment tool according to the third aspect, the driving manipulation member may move from a start position to an end position or from the end position to the start position substantially in one direction with respect to the manipulation unit main body The rotational center switch unit may switch a rotational center of the driving manipulation member with respect to the manipulation unit main body from the first rotational center to the second rotational center or from the second rotational center to the first rotational center at at least one location between the start position and the end position. Provided that a magnitude of a force applied to the driving manipulation member is set as Fin, a magnitude of a force of driving the driving force transmission member via the switch unit is set as Fout, a distance between an input section and the first rotational center when a predetermined point at which a force is applied to the driving manipulation member to manipulate the driving manipulation member is designated as the input section is set as L1, a distance between a connecting position of the driving force transmission member to the driving manipulation member and the first rotational center is set as L2, a distance between the input section and the second rotational center is set as L3, and a distance between the connecting position and the second rotational center is set as L4, a relational expression in the first state is Fout/Fin = L1/L2, a relational expression in the second state is Fout/Fin = L3/L4, and L1/L2 < L3/L4. - According to the treatment tool, it is possible to appropriately grip the target by merely moving the driving manipulation member by the treatment tool in substantially one direction between the first position and the second position.
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FIG. 1 is a side view showing a treatment tool according to a first embodiment of the present invention. -
FIG 2 is a side view showing a handle mechanism installed at the treatment tool according to the first embodiment of the present invention. -
FIG. 3 is a perspective view showing a portion of a driving manipulation member installed at the handle mechanism. -
FIG 4 is a schematic view showing an operational principal of the handle mechanism. -
FIG. 5 is a side view showing a handle mechanism according to a first modified example of the present invention. -
FIG. 6 is a side view showing a handle mechanism according to a second modified example of the present invention. -
FIG 7 is a side view showing a handle mechanism according to a third modified example of the present invention. -
FIG 8 is a side view showing a handle mechanism according to a second embodiment of the present invention. -
FIG 9 is a side view showing a handle mechanism according to a fourth modified example of the present invention. -
FIG 10 is a side view showing a handle mechanism - A treatment tool 1 of a first embodiment according to the present invention will be described.
FIG. 1 is a side view of the treatment tool according to the first embodiment of the present invention.FIG 2 is a side view showing a handle mechanism installed at the treatment tool.FIG. 3 is a perspective view showing a portion of a driving manipulation member installed at the handle mechanism.FIG. 4 is a schematic view showing an operational principle of the handle mechanism. - The treatment tool 1 includes a long insertion section (a long shaft member) 2, a treatment unit 3, a
manipulation unit 6, and a drivingforce transmission member 30. The treatment unit 3 is installed at a distal end (a distal end portion) 2a of the insertion section 2. Themanipulation unit 6 is installed at a proximal end (a proximal end portion) 2b of the insertion section 2 to manipulate the treatment unit 3. The drivingforce transmission member 30 is connected to themanipulation unit 6 and the treatment unit 3. - The insertion section 2 is a tubular member having flexibility, into which the driving
force transmission member 30 is inserted so as to advance and retract along alongitudinal axis 2c of the insertion section 2. In the embodiment, the insertion section 2 is constituted by a coil sheath on which a flexible wire rod is wound. The insertion section 2 constituted by the coil sheath has a high tolerance with respect to compression of the insertion section 2 in a central axis direction. In addition, the insertion section 2 can transmit a rotational force when a proximal end of the insertion section 2 is rotated about a central axis as a rotational force for rotating a distal end of the insertion section 2 about the central axis. - The treatment unit 3 has a pair of jaws 4 opened and closed by linear movement of the driving
force transmission member 30 in the central axis direction of the insertion section 2. The jaws 4 are connected to a distal end of the drivingforce transmission member 30 via a known link mechanism 5. A force transmitted via the drivingforce transmission member 30 is converted into a force for opening/closing the jaws 4 by the link mechanism 5. In the embodiment, when the drivingforce transmission member 30 is moved toward the distal end of the insertion section 2, the pair of jaws 4 are open (a first position), and when the drivingforce transmission member 30 is moved toward a proximal end of the insertion section 2, the pair of jaws 4 are closed (a second position). - In addition, the treatment unit 3 may include, instead of the pair of jaws 4 that can be opened and closed, such as other forceps, a stapler, a clip, a needle holder, and the like. In this case, the link mechanism 5 is configured to convert a linear movement of the driving
force transmission member 30 into an operation of the treatment unit 3. - The
manipulation unit 6 includes an exterior body (a manipulation unit main body) 7 connected to the proximal end of the insertion section 2, and ahandle mechanism 10 partially installed in theexterior body 7. - A
grip 8 held by an operator to manipulate adriving manipulation member 11 is formed at theexterior body 7. Thegrip 8 is a rod-shaped member extending in substantially the same direction as a direction in which thedriving manipulation member 11 protrudes from theexterior body 7. - As shown in
FIG. 2 , thehandle mechanism 10 includes thedriving manipulation member 11, and aswitch unit 20. Thedriving manipulation member 11 is configured to be connected to the proximal end of the drivingforce transmission member 30 in theexterior body 7 and protrude to the outside of theexterior body 7. Theswitch unit 20 is installed in theexterior body 7 and connected to thedriving manipulation member 11 in theexterior body 7. - The driving
manipulation member 11 includes atrigger section 12 on which an operator's finger is set, and a connectingsection 14 connected to theswitch unit 20. - A portion of the
trigger section 12 within a range with which the operator's finger can come in contact when the operator manipulates the treatment tool 1 using thetrigger section 12, constitutes aninput section 13 into which a manipulation amount is input by the operator. A leverage point P6 based on design is previously determined on theinput section 13. Theswitch unit 20 is designed on the assumption that the operator applies a force to the leverage point P6 based on design. - The driving
manipulation member 11 is moved with respect to theexterior body 7 of themanipulation unit 6 by the operator's finger put on thetrigger section 12. - As shown in
FIGS. 2 and3 , the connectingsection 14 has afirst pin 15 and asecond pin 16 disposed in theexterior body 7. Thefirst pin 15 and thesecond pin 16 are substantially columnar shaped members having central axes O1 and O2 parallel to each other. In the embodiment,bearings 18 rotatable about the central axes O1 and O2 as rotational centers are inserted into thefirst pin 15 and thesecond pin 16. In the embodiment, thebearings 18 have outer circumferential surfaces formed columnar and are rotated about the rotational center upon contact with slide rails 22 (to be described later). - As shown in
FIG. 2 , theswitch unit 20 is installed at themanipulation unit 6 in an attempt to get the treatment unit 3 to be operated between the first position and the second position and to switch a ratio of a movement amount of the drivingforce transmission member 30 with respect to a movement amount of the drivingmanipulation member 11. Theswitch unit 20 has a base 21 disposed in themanipulation unit 6 and fixed to themanipulation unit 6, and the slide rails 22 installed at thebase 21. - The slide rails 22 formed at the base 21 include a
first slide rail 23 and asecond slide rail 24. Thefirst slide rail 23 is a linear slide rail extending to be parallel to a direction in which the insertion section 2 protrudes from themanipulation unit 6. Thesecond slide rail 24 is a slide rail formed at a position spaced apart from thefirst slide rail 23. - The
first slide rail 23 is a groove or a through-hole formed in thebase 21. In thefirst slide rail 23, a pair of inner surfaces extending in a longitudinal direction of thefirst slide rail 23 is parallel to each other. A distance between the pair of inner surfaces is slightly larger than an outer dimension of the bearing 18 attached to thefirst pin 15. - As an outer circumferential surface of the bearing 18 attached to the
first pin 15 comes in contact with an inner surface of thefirst slide rail 23, thefirst pin 15 is guided in the longitudinal direction of thefirst slide rail 23. - The
second slide rail 24 is configured by a groove or a through-hole formed in thebase 21. Thesecond slide rail 24 has alinear section 25 parallel to thefirst slide rail 23, and an arc-shapedsection 26 connected to thelinear section 25. - The
second pin 16 to which thebearing 18 is attached is inserted into thelinear section 25 and the arc-shapedsection 26, and an outer circumferential surface of the bearing 18 attached to thesecond pin 16 comes in contact with an inner surface of thelinear section 25 or the arc-shapedsection 26. - The arc-shaped
section 26 is formed in an arc shape centered on an end section of the proximal end side of thefirst slide rail 23. Specifically, a position of a central axis of thefirst pin 15 when the bearing 18 of thefirst pin 15 abuts the end section of the proximal end side of thefirst slide rail 23 is positioned at a center of an arc portion of the arc-shapedsection 26. An end section of the arc-shapedsection 26 opposite to a side thereof connected to thelinear section 25 has a semi-circular shape conforming to a shape of the outer circumferential surface of thebearing 18. - A distance between the
first slide rail 23 and thesecond slide rail 24 is substantially equal to a distance between thefirst pin 15 and thesecond pin 16. The drivingmanipulation member 11 into which thesecond pin 16 and thefirst pin 15 are inserted is supported in thelinear section 25 of thesecond slide rail 24 and thefirst slide rail 23 such that the drivingmanipulation member 11 can be linearly moved. Moreover, the drivingmanipulation member 11 is supported in the arc-shapedsection 26 of thesecond slide rail 24 and thefirst slide rail 23. The drivingmanipulation member 11 is supported by the slide rail such that thesecond pin 16 can be pivoted along the arc-shapedsection 26 about the central axis of thefirst pin 15. - When the
first pin 15 is positioned at the end section of the distal end side of thefirst slide rail 23 and thesecond pin 16 is positioned at the end section of the distal end side of thesecond slide rail 24, the pair of jaws 4 are completely open. In the embodiment, this position is referred to as "a start position." - In addition, as the driving
manipulation member 11 is moved along the slide rails 22, when thefirst pin 15 is positioned at the end section of the proximal end side of thefirst slide rail 23 and thesecond pin 16 is positioned at the end section of the proximal end side of thesecond slide rail 24, the pair of jaws 4 are completely closed. In the embodiment, this position is referred to as "an end position." - In the embodiment, the driving
manipulation member 11 is moved with respect to themanipulation unit 6 in substantially one direction between the start position and the end position. - In addition, in the embodiment, the
second slide rail 24 of the slide rails 22 has a shape in which thelinear section 25 and the arc-shapedsection 26 are formed continuously each other. For this reason, a moving direction in which the drivingmanipulation member 11 is moved along thelinear section 25 and a direction in which the drivingmanipulation member 11 is moved along the arc-shapedsection 26 are not one direction in the strict sense. In the embodiment, "the approximately one direction" includes the case in which the moving direction is varied such that the moving direction of the drivingmanipulation member 11 is not reversed when the drivingmanipulation member 11 is moved from the start position to the end position or when the drivingmanipulation member 11 is moved from the end position to the start position. - A rotational center switch unit configured to switch a rotational center of the driving
manipulation member 11 is constituted by thefirst pin 15 and thesecond pin 16 which are formed at the drivingmanipulation member 11, and thefirst slide rail 23 and thesecond slide rail 24 which are formed at thebase 21. - In the embodiment, the
first slide rail 23 is formed linearly, and thelinear section 25 of thesecond slide rail 24 is formed linearly in parallel with thefirst slide rail 23. As shown inFIGS. 2 and4 , the drivingmanipulation member 11 in a state in which thefirst pin 15 is inserted into thefirst slide rail 23 and thesecond pin 16 is inserted into thelinear section 25 may be said to be rotated about an imaginary rotational center disposed at a position spaced an infinite distance from thefirst slide rail 23. - In the embodiment, the imaginary rotational center is referred to as a first rotational center R1, and a position of the central axis of the
first pin 15 when thefirst pin 15 is disposed at the end section of the proximal end side of thefirst slide rail 23 is referred to as a second rotational center R2. In addition, in the embodiment, a state in which the drivingmanipulation member 11 is rotated about the first rotational center R1 is referred to as a first state, and a state in which the drivingmanipulation member 11 is rotated about the second rotational center R2 is referred to as a second state. - The rotational center switch unit switches a rotational center of the driving
manipulation member 11 with respect to themanipulation unit 6 from the first rotational center R1 to the second rotational center R2 or from the second rotational center R2 to the first rotational center R1 at a position between the start position and the end position, and at a boundary between thelinear section 25 and the arc-shapedsection 26. That is, the first state and the second state are switched by the rotational center switch unit. - As shown in
FIGS. 1 and2 , the drivingforce transmission member 30 is formed of a wire rod having flexibility and high strength against compression or tension in the central axis direction. The drivingforce transmission member 30 is pulled by the drivingmanipulation member 11, and transmits a force needed to drive the treatment unit 3 from themanipulation unit 6 to the treatment unit 3. - Next, in a configuration of a major part of the
handle mechanism 10, a magnitude correlation of the force when the rotational center is switched by the rotational center switch unit will be described with reference toFIG. 4 . - The
handle mechanism 10 according to the embodiment is designed on the assumption that a force is applied from the operator to the leverage point P6 based on design of theinput section 13. A magnitude of a force applied to the drivingmanipulation member 11 by the operator is set as Fin. A magnitude of a force driven by the drivingforce transmission member 30 via theswitch unit 20 is set as Fout. A distance between the leverage point P6 of theinput section 13 and the first rotational center R1 is set as L1. A distance between a connecting position at which the drivingforce transmission member 30 is connected to the drivingmanipulation member 11 and the first rotational center R1 is set as L2. A distance between the leverage point P6 of theinput section 13 and the second rotational center R2 is set as L3. A distance between the connecting position and the second rotational center R2 is set as L4. Here, a relational expression in the first state is Fout/Fin = L1/L2, and a relational expression in the second state is Fout/Fin = L3/L4. - In addition, in the embodiment, the relational expression of them is L1/L2 < L3/L4. That is, in the second state, in comparison with the first state, a force applied to the driving
force transmission member 30 is larger than a force input to theinput section 13. This is because the input to theinput section 13 is reduced to be transmitted to the drivingforce transmission member 30 according to the principle of leverage. - An operation of the
handle mechanism 10 having the above-mentioned configuration will be described along with an operation of the treatment tool 1 in use. - When using the treatment tool 1, for example, the treatment tool 1 is set in a treatment tool channel of a flexible endoscope (not shown), and guides the treatment unit 3 to a treatment target.
- The operator of the treatment tool 1 grips the
grip 8 of themanipulation unit 6, puts his/her finger on the drivingmanipulation member 11 protruding from theexterior body 7, and moves the drivingmanipulation member 11 with respect to themanipulation unit 6 in a desired direction. For example, when the drivingmanipulation member 11 is moved from the start position to the end position, the drivingforce transmission member 30 is moved in a direction from the distal end of the insertion section 2 toward the proximal end by the force moving the drivingmanipulation member 11, and the pair of jaws 4 are changed from a completely open state (a first position) to a completely closed state (a second position). When the pair of jaws 4 are in the completely closed state, thesecond pin 16 is disposed slightly closer to the distal end side than the end section of the proximal end side of the arc-shapedsection 26. For this reason, when the drivingmanipulation member 11 is further moved until the bearing 18 of thesecond pin 16 comes in contact with the end section of the proximal end side of the arc-shapedsection 26, a force in a closing direction of the pair of jaws 4 can be applied to the pair of jaws 4 in the completely closed state. Accordingly, the pair of jaws 4 can be securely closed even when expansion and contraction of the insertion section 2 or expansion and contraction of the drivingforce transmission member 30 occur. - For example, while the driving
manipulation member 11 is moved with respect to themanipulation unit 6 from the start position to the end position, the moving state of the drivingmanipulation member 11 with respect to themanipulation unit 6 is switched from the first state to the second state by theswitch unit 20. Specifically, the moving state of the drivingmanipulation member 11 with respect to themanipulation unit 6 is switched from the first state in which the drivingmanipulation member 11 is rotated with respect to themanipulation unit 6 about the first rotational center R1 to the second state in which the drivingmanipulation member 11 is rotated with respect to themanipulation unit 6 about the second rotational center R2 different from the first rotational center R1. In the first state, a movement amount of the drivingmanipulation member 11 is equal to a movement amount of the drivingforce transmission member 30. In addition, in the second state, the movement amount of the drivingforce transmission member 30 is smaller than that of the drivingmanipulation member 11. In the second state, the movement amount of the drivingforce transmission member 30 is reduced with respect to the movement amount of the drivingmanipulation member 11 and a force applied to the treatment unit 3 is increased accordingly. For this reason, in the second state, the gripping target can be gripped by the pair of jaws 4 with a force larger than that of the first state. In addition, in the first state, the pair of jaws 4 can be rapidly moved in a state in which the gripping target is not separately gripped. - Since the conventional handle mechanism das not have a mechanism for varying a reduction ratio between the first state and the second state, even when a range in which a large force needs to be applied and a range in which rapid movement is preferable are provided, the moving speed of the treatment unit with respect to the moving speed of the driving manipulation member or the force applied to the driving manipulation member by the operator and the force of operating the treatment unit are not varied from a constant relation.
- On the other hand, according to the
handle mechanism 10 of the embodiment, a mechanism for varying a reduction ratio between the first state and the second state is provided. For this reason, each of the jaws 4 can be rapidly moved in the first state at a position near the position where a position in the state that the pair of jaws 4 are completely opened within the movable range in which the pair of jaws 4 are opened and closed, and a larger force than that of the first state can be applied to the pair of jaws 4 in the second state at a position near the position where a position in a state that the pair of jaws 4 are completely closed within the movable range in which the pair of jaws 4 are opened and closed. During the treatment, for example, the gripping target having elasticity such as a biological tissue or the like may be grasped using the pair of jaws 4 by closing the pair of jaws 4. Here, as the jaws approach the completely closed state, the force required to close the pair of jaws 4 is increased. For this reason, as described in the embodiment, the gripping target can be appropriately grasped by only moving the drivingmanipulation member 11 substantially in one direction within a state that the pair of jaws 4 are positioned from the completely open state to the completely closed state. - In addition, in the first state, a circumstance in which the driving
manipulation member 11 cannot be easily moved due to elasticity of the gripping target harder occurs than the case in which the gripping target is grasped by the pair of jaws 4 in the second state. Accordingly, even when the movement amount of the drivingmanipulation member 11 is set to be smaller than that of the drivingforce transmission member 30, probability that a force for opening or closing the pair of jaws 4 become insufficient is low. - In the embodiment, the movable range of the driving
manipulation member 11 with respect to themanipulation unit 6 is preferably within a range in which the drivingmanipulation member 11 can be moved by the operator opens or closes his/her hand. For this reason, the movable range of the drivingmanipulation member 11 has an upper limit. Here, as the movement amount of moving the drivingmanipulation member 11 is reduced in the first state, the movement amount of moving the drivingmanipulation member 11 can be set to be large in the second state. For this reason, even in a state in which the movable range of the drivingmanipulation member 11 is limited, the opening/closing movement amount of the pair of jaws 4 can be sufficiently secured and a force having a sufficient magnitude with respect to the pair of jaws 4 can be applied. - In addition, in the first state, the driving
manipulation member 11 is actually moved linearly because the first rotational center R1 is disposed at a position of an infinite distance. For this reason, the drivingmanipulation member 11 is moved linearly in the first state and rotated in the second state, and movement of the drivingmanipulation member 11 is remarkably changed at a position at which the first state and the second state are switched. As a result, the operator who manipulates the treatment tool 1 can easily recognize whether thehandle mechanism 10 is in the first state or the second state. - Next, a first modified example of the
handle mechanism 10 described in the above-mentioned first embodiment will be described with reference toFIG. 5. FIG 5 is a side view showing a handle mechanism of the modified example. - As shown in
FIG 5 , the modified example is different from the above-mentioned first embodiment in that thehandle mechanism 10 is reversely disposed back and forth. That is, the arc-shapedsection 26 of thesecond slide rail 24 is disposed at the distal end side of themanipulation unit 6. - In addition, in the case of the modified example, the driving
manipulation member 11 has a shape so as to easily hook a finger while the drivingmanipulation member 11 is pushed toward the distal end. Specifically, a ring portion through which a finger can pass is formed at the drivingmanipulation member 11. - Even in the above-mentioned configuration, the same effect as the
handle mechanism 10 described in the first embodiment is exhibited. - Further, in the case of the modified example, if the driving
manipulation member 11 is moved from the distal end side to the proximal end side of themanipulation unit 6, when the position of thesecond pin 16 is switched from the arc-shapedsection 26 to thelinear section 25 of thesecond slide rail 24, a magnitude of force required for the operator to manipulate the drivingmanipulation member 11 is increased. Accordingly, the operator can recognize that the operator has been operated a given amount of work for which the drivingmanipulation member 11 is moved to reach the proximal end through a feeling of the finger in contact with the drivingmanipulation member 11. - For example, in the grasping forceps or the like, as a magnitude of force for manipulation is switched as described above, the operator can recognize that the operator has gripped the driving
manipulation member 11 with a given amount of distance. That is, the operator can recognize that the grasping forceps is closed until a predetermined position. Accordingly, it is possible to suppress to grasp the biological tissue or the like with an excessively strong force by the grasping forceps. - Next, a second modified example of the
handle mechanism 10 described in the above-mentioned first embodiment will be described with reference toFIG. 6. FIG 6 is a side view showing a handle mechanism of the modified example. - As shown in
FIG. 6 , the modified example is different from the above-mentioned first embodiment in that a radius of the arc-shapedsection 26 is larger than that of the arc-shapedsection 26 of the first embodiment. In addition, thelinear section 25 of thesecond slide rail 24 is offset closer to the distal end side than thelinear section 25 described in the first embodiment. - Even in the above-mentioned configuration, the same effect as the
handle mechanism 10 described in the first embodiment is exhibited. - Next, a third modified example of the
handle mechanism 10 described in the above-mentioned first embodiment will be described with reference toFIG. 7. FIG. 7 is a side view showing a handle mechanism of the modified example. - As shown in
FIG 7 , the modified example is different from the first embodiment in that the arc-shapedsection 26 is formed at thefirst slide rail 23. That is, in the case of the modified example, thesecond pin 16 is supported at the end section of the proximal end side of thelinear section 25 of thesecond slide rail 24. Then, a position of the central axis of thesecond pin 16 is a rotary shaft corresponding to the second rotational center R2 described in the above-mentioned first embodiment. In a state in which thesecond pin 16 is supported at the end section of the proximal end side of thelinear section 25 of thesecond slide rail 24, when theinput section 13 of the drivingmanipulation member 11 is moved toward the proximal end side of themanipulation unit 6, thefirst pin 15 is moved toward the distal end along the arc-shapedsection 26 about a position of the central axis of thesecond pin 16 as a rotational center. - Even in the above-mentioned configuration, the same effect as the
handle mechanism 10 described in the first embodiment is exhibited. - In addition, since the arc-shaped
section 26 is disposed between thefirst slide rail 23 and thelinear section 25, thehandle mechanism 10 can be miniaturized compared to the first embodiment. - Next, a
handle mechanism 10A of a second embodiment of the present invention will be described. Hereinafter, the same components as those described in the above-mentioned first embodiment are designated by the same reference numerals, and description thereof will be omitted.FIG 8 is a side view showing a handle mechanism according to the embodiment. - As shown in
FIG. 8 , unlike the first embodiment, thehandle mechanism 10A includes a drivingmanipulation member 11A instead of the drivingmanipulation member 11, and aswitch unit 20A instead of theswitch unit 20. - The driving
manipulation member 11 A further includes athird pin 17 in addition to thefirst pin 15 and thesecond pin 16. Thefirst pin 15, thesecond pin 16 and thethird pin 17 are disposed in parallel on a straight line. The above-mentioned bearing 18 (seeFIG. 3 ) is attached to thethird pin 17. - The
switch unit 20A includes afirst slide rail 23A, asecond slide rail 24A and athird slide rail 27A. Thefirst slide rail 23A is formed in an arc shape about a first rotational center R1A set at a position different from the first rotational center R1. Thesecond slide rail 24A and thethird slide rail 27A are formed apart from thefirst slide rail 23A. - The
second slide rail 24A includes a first arc-shapedsection 25A and a second arc-shapedsection 26A. The first arc-shapedsection 25A is concentrically formed with thefirst slide rail 23A, and formed in an arc shape parallel to thefirst slide rail 23A. The second arc-shapedsection 26A is formed in an arc shape having a larger radius of curvature than that of the first arc-shapedsection 25A. - The
third slide rail 27A is formed in an arc shape concentric with the second arc-shapedsection 26A. The end section of the proximal end side of thethird slide rail 27A is disposed on a straight line passing through a boundary between the first arc-shapedsection 25A and the second arc-shapedsection 26A, and the end section of the proximal end side of thefirst slide rail 23A. The end section of the distal end side of thethird slide rail 27A is disposed on a straight line passing through the end section of the proximal end side of the second arc-shapedsection 26A and the end section of the proximal end side of thefirst slide rail 23A. - In the embodiment, a state in which the
second pin 16 is moved along the first arc-shapedsection 25A is a first state in which the drivingmanipulation member 11 A is moved about the first rotational center R1A. In addition, a state in which thesecond pin 16 is moved along the second arc-shapedsection 26A is a second state in which the drivingmanipulation member 11 A is moved about the second rotational center R2A. - In the embodiment, similar to the first embodiment, a relational expression in the first state is Fout/Fin = L1/L2, and a relational expression in the second state is Fout/Fin = L3/L4. In the embodiment, a relational expression is L1/L2 < L3/L4.
- Next, an operation of the
handle mechanism 10 according to the embodiment will be described. - A center of the arc of the
third slide rail 27A is the above-mentioned second rotational center R2A, and thethird pin 17 is fixed to the end section of the proximal end side of thethird slide rail 27A until thefirst pin 15 is moved to the end section of the proximal end side of thefirst slide rail 23A. - When the driving
manipulation member 11 A is moved until thefirst pin 15 comes in contact with the end section of the proximal end side of thefirst slide rail 23A, thesecond pin 16 is positioned at a boundary between the first arc-shapedsection 25A and the second arc-shapedsection 26A. After that, when the drivingmanipulation member 11 A is further moved, thesecond pin 16 is moved toward the proximal end of the second arc-shapedsection 26A. Here, since thethird slide rail 27A is formed in an arc shape having the same rotational center as the second arc-shapedsection 26A, the drivingmanipulation member 11 A is rotated about a position of the central axis of thefirst pin 15 in contact with the end section of the proximal end side of thefirst slide rail 23A as a rotational center. - Even in the embodiment, similar to the
handle mechanism 10 of the first embodiment, a reduction ratio between the first state and the second state is varied. - In addition, the
first pin 15, thesecond pin 16 and thethird pin 17 may not be disposed in parallel on the same straight line. - Next, a modified example of the
handle mechanism 10A described in the second embodiment will be described with reference toFIG. 9. FIG. 9 is a side view showing a handle mechanism of the modified example. - As shown in
FIG 9 , in the modified example, afourth slide rail 28 branched off from the proximal end of thefirst slide rail 23A, formed in an arc shape about the proximal end of the second arc-shapedsection 26A and extending toward the distal end side is provided with thefirst slide rail 23A. Further, a third arc-shapedsection 29 positioned closer to the distal end side than the distal end of thethird slide rail 27A described in the second embodiment and formed in an arc shape having the same rotational center as thefourth slide rail 28 is formed at thethird slide rail 27A. - In the modified example, when the driving
manipulation member 11A is further moved toward the proximal end from a state in which thesecond pin 16 is positioned at the end section of the proximal end side of the second arc-shapedsection 26A, the drivingmanipulation member 11A is rotated about a position of the central axis of thesecond pin 16 as a rotational center. A position of the central axis of thesecond pin 16 in a state in which thesecond pin 16 is positioned at the end section of the proximal end side of the second arc-shapedsection 26A is a third rotational center R3 configured to transmit a force to the drivingforce transmission member 30 from the drivingmanipulation member 11A at a reduction ratio different from the first state and second state. Hereinafter, a state in which the drivingmanipulation member 11 is rotated about the third rotational center R3 is referred to as "a third state." - In the case of the modified example, when the driving
manipulation member 11A is moved from the distal end side toward the proximal end substantially in one direction, the first state in which the drivingmanipulation member 11 is rotated about the first rotational center R1A, the second state in which the drivingmanipulation member 11 is rotated about the second rotational center R2A, and the third state in which the drivingmanipulation member 11 is rotated about the third rotational center R3 are sequentially switched. Accordingly, the magnitude of the force applied to the treatment unit 3 including the pair of jaws 4 or the like can be switched in three stages. - In addition, as the slide rails having different radii of curvature are combined, the switching of the magnitude of the force applied to the treatment unit 3 may be performed in more than three stages.
- Next, a treatment tool according to an example will be described.
FIG 10 is a side view showing ahandle mechanism 10B. - As shown in
FIG 10 , thehandle mechanism 10B is different from the first embodiment in that the drivingmanipulation member 11 is moved linearly in both of the first state and the second state described in the above-mentioned first embodiment. - That is, in the
handle mechanism 10B, thefirst slide rail 23 has alinear section 23B formed at a distal end side of themanipulation unit 6 and a secondlinear section 23C formed at a proximal end side of themanipulation unit 6, and thesecond slide rail 24 has alinear section 25B formed at the distal end side of themanipulation unit 6 and a secondlinear section 25C formed at the proximal end side of themanipulation unit 6. - The second
linear sections linear sections first slide rail 23 and thesecond slide rail 24 are formed in parallel between the distal end side and the proximal end side of themanipulation unit 6. - In addition, a
pulley 31 having an outer surface in contact with the drivingforce transmission member 30 is fixed to themanipulation unit 6. Thepulley 31 is disposed near a boundary portion between thelinear section 25B and the secondlinear section 25C. - Next, an operation of the
handle mechanism 10B will be described. - When the driving
manipulation member 11 is moved from the distal end to the proximal end of themanipulation unit 6, first, the drivingmanipulation member 11 is moved linearly along thelinear sections first slide rail 23 and thesecond slide rail 24. Then, thefirst pin 15 and thesecond pin 16 installed at the drivingmanipulation member 11 are moved to the secondlinear sections linear sections manipulation member 11 is varied by the angle θ. In addition, when the proximal end of the drivingforce transmission member 30 is moved closer to the proximal end side of themanipulation unit 6 than thepulley 31, the drivingforce transmission member 30 comes in contact with the outer surface of thepulley 31. The drivingforce transmission member 30 in contact with the outer surface of thepulley 31 is in a state bent by thepulley 31 to the angle θ. - Accordingly, in the second
linear sections force transmission member 30 is pulled in a state in which a reduction ratio is reduced to arrive at 1:(1/cosθ) with respect to the linear sections. - In the treatment tool according to the embodiment, when the operator grips the
handle mechanism 10B until quantity of movement of thehandle mechanism 10B becomes a given amount, thehandle mechanism 10B is switched to a low reduction ratio. Here, since a magnitude of force required for the operator to operate the handle is increased, the operator can instinctively recognize that the operator has operated the handle until quantity of movement of thehandle mechanism 10B becomes a given amount. - In addition, similar to first modified example, the second linear sections may be disposed at the distal end side of the
manipulation unit 6. In this case, as the drivingmanipulation member 11 is moved from the distal end to the proximal end, a manipulation feeling is varied to be lighter. - Hereinabove, while the exemplary embodiments of the present invention have been described, the present invention is not limited to these embodiments. Addition, omission, substitution, and other modifications of components can be made without departing from the present invention.
- For example, in addition to the configurations described in the above-mentioned embodiments and the modified examples, a configuration in which a first state is a state in which the driving manipulation member is rotated and a second state is a state in which the driving manipulation member is moved linearly can be used.
- According to the treatment tool, the treatment tool can appropriately grip the target to be gripped by merely moving the driving manipulation member by the treatment tool in substantially one direction between the first position and the second position.
-
- 1
- treatment tool
- 2
- insertion section (long shaft member)
- 3
- treatment unit
- 4
- jaw
- 6
- manipulation unit
- 7
- exterior body (manipulation unit main body)
- 10
- handle mechanism
- 11
- driving manipulation member
- 15
- first pin (rotational center switch unit)
- 16
- second pin (rotational center switch unit)
- 20
- switch unit
- 23
- first slide rail (rotational center switch unit)
- 24
- second slide rail (rotational center switch unit)
- 30
- driving force transmission member
- R1
- first rotational center
- R2
- second rotational center
Claims (2)
- A treatment tool (1) comprising:a long shaft member (2) having a distal end portion (2a) and a proximal end portion (2b), and a longitudinal axis (2c) extending from the distal end portion (2a) to the proximal end portion (2b);a pair of grasping members (4) installed at the distal end portion (2a) of the long shaft member (2) so as to be freely opened and closed with each other to grasp a target area;a driving force transmission member (30) connected to the pair of grasping members (4) and extending along the longitudinal axis (2c) so as to be freely moved along the longitudinal axis (2c) with respect to the long shaft member (2);a driving manipulation member (11) connected to a proximal end portion of the driving force transmission member (30) and configured to be capable of being manipulated so that the driving force transmission member (30) moves with respect to the long shaft member (2); anda manipulation unit main body (7) installed at the proximal end portion (2b) of the long shaft member (2), wherein the driving manipulation member (11) is movable with respect to the manipulation unit main body (7),characterized by a switch unit (20) configured to switch a moving state of the driving manipulation member (11) with respect to the manipulation unit main body (7) into a moving state of one of a first state in which the driving manipulation member (11) is rotated about a first rotational center (R1) with respect to the manipulation unit main body (7) by a first sliding section (25; 25A) supporting the driving manipulation member (11) and a second state in which the driving manipulation member (11) is rotated about a second rotational center (R2) different from the first rotational center (R1) with respect to the manipulation unit main body (7) by a second sliding section (26; 26A) formed continuously to the first sliding section (25; 25A) supporting the driving manipulation member (11).
- The treatment tool (1) according to Claim 1, wherein
the driving manipulation member (11) moves from a start position to an end position or from the end position to the start position in substantially one direction with respect to the manipulation unit main body (7),
the switch unit (20) switches a rotational center of the driving manipulation member with respect to the manipulation unit main body (7) from the first rotational center (R1) to the second rotational center (R2) or from the second rotational center (R2) to the first rotational center (R1) at at least one place between the start position and the end position, and
provided that a magnitude of a force applied to the driving manipulation member (11) is set as Fin, a magnitude of a force for driving the driving force transmission member (30) via the switch unit (20) is set as Fout, a distance between an input section (13) and the first rotational center (R1) when a predetermined point at which a force is applied to the driving manipulation member (11) to manipulate the driving manipulation member (11) is designated as the input section (13) is set as L1, a distance between a connecting position of the driving force transmission member (30) to the driving manipulation member (11) and the first rotational center (R1) is set as L2, a distance between the input section (13) and the second rotational center (R2) is set as L3, and a distance between the connecting position and the second rotational center (R2) is set as L4,
a relational expression in the first state is Fout/Fin = L1/L2,
a relational expression in the second state is Fout/Fin = L3/L4, and
a relational expression is L1/L2 < L3/L4.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161515430P | 2011-08-05 | 2011-08-05 | |
PCT/JP2012/069352 WO2013021850A1 (en) | 2011-08-05 | 2012-07-30 | Therapeutic implement |
Publications (3)
Publication Number | Publication Date |
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EP2740420A1 EP2740420A1 (en) | 2014-06-11 |
EP2740420A4 EP2740420A4 (en) | 2015-04-08 |
EP2740420B1 true EP2740420B1 (en) | 2016-10-12 |
Family
ID=47668362
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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EP12822837.6A Active EP2740420B1 (en) | 2011-08-05 | 2012-07-30 | Treatment tool |
Country Status (5)
Country | Link |
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US (1) | US8821531B2 (en) |
EP (1) | EP2740420B1 (en) |
JP (1) | JP5326067B2 (en) |
CN (1) | CN103476352B (en) |
WO (1) | WO2013021850A1 (en) |
Families Citing this family (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10675019B2 (en) * | 2014-11-04 | 2020-06-09 | Rotation Medical, Inc. | Medical implant delivery system and related methods |
CA2965853A1 (en) | 2014-11-04 | 2016-05-12 | Rotation Medical, Inc. | Medical implant delivery system and related methods |
EP3215026B1 (en) | 2014-11-04 | 2023-10-25 | Rotation Medical, Inc. | Medical implant delivery system |
US10226269B2 (en) | 2015-05-27 | 2019-03-12 | Covidien Lp | Surgical forceps |
US10758228B2 (en) | 2015-11-03 | 2020-09-01 | Rotation Medical, Inc. | Fastener delivery system and related methods |
US10433842B2 (en) | 2017-04-07 | 2019-10-08 | Lexington Medical, Inc. | Surgical handle assembly |
US10912560B2 (en) | 2017-06-23 | 2021-02-09 | Lexington Medical, Inc. | Surgical reloadable cartridge assembly |
WO2019008631A1 (en) | 2017-07-03 | 2019-01-10 | オリンパス株式会社 | Medical device and surgical system |
US11166723B2 (en) | 2018-09-21 | 2021-11-09 | Lexington Medical, Inc. | Surgical handle assembly modes of operation |
US10856871B2 (en) | 2019-01-16 | 2020-12-08 | Lexington Medical, Inc. | Advancing a toothed rack of a surgical handle assembly |
US11298131B2 (en) | 2020-01-15 | 2022-04-12 | Lexington Medical, Inc. | Multidirectional apparatus |
US11116501B1 (en) | 2020-04-10 | 2021-09-14 | Lexington Medical, Inc. | Surgical handle articulation assemblies |
US11864757B2 (en) | 2021-01-15 | 2024-01-09 | Lexington, Medical, Inc. | Reloadable cartridge assembly |
US11622764B2 (en) | 2021-04-27 | 2023-04-11 | Lexington Medical, Inc. | Surgical handle assembly |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH06296618A (en) | 1993-04-14 | 1994-10-25 | Olympus Optical Co Ltd | Clamping forceps |
JPH0871072A (en) * | 1994-09-01 | 1996-03-19 | Olympus Optical Co Ltd | Manipulator system for operation |
ES2150533T3 (en) * | 1995-03-15 | 2000-12-01 | Ethicon Endo Surgery Inc | INSTRUMENT TO APPLY SURGICAL CLIPS. |
US7223273B2 (en) * | 1996-07-23 | 2007-05-29 | Tyco Healthcare Group Lp | Anastomosis instrument and method for performing same |
US6544274B2 (en) * | 2001-05-02 | 2003-04-08 | Novare Surgical Systems, Inc. | Clamp having bendable shaft |
US7241264B2 (en) * | 2003-06-30 | 2007-07-10 | Ethicon, Inc. | Variable-pitch cam mechanism for tension devices |
ATE534338T1 (en) * | 2006-10-13 | 2011-12-15 | Terumo Corp | MANIPULATOR |
JP2008093271A (en) * | 2006-10-13 | 2008-04-24 | Terumo Corp | Manipulator |
FR2913783B1 (en) * | 2007-03-14 | 2009-10-09 | Landanger Sa | HANDLE ASSEMBLY, IN PARTICULAR FOR ENDOSCOPIC SURGICAL INSTRUMENT |
-
2012
- 2012-07-30 JP JP2013519288A patent/JP5326067B2/en active Active
- 2012-07-30 CN CN201280014882.6A patent/CN103476352B/en active Active
- 2012-07-30 WO PCT/JP2012/069352 patent/WO2013021850A1/en active Application Filing
- 2012-07-30 EP EP12822837.6A patent/EP2740420B1/en active Active
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2013
- 2013-04-19 US US13/866,653 patent/US8821531B2/en active Active
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US20130304115A1 (en) | 2013-11-14 |
JP5326067B2 (en) | 2013-10-30 |
US8821531B2 (en) | 2014-09-02 |
JPWO2013021850A1 (en) | 2015-03-05 |
CN103476352B (en) | 2016-03-09 |
CN103476352A (en) | 2013-12-25 |
WO2013021850A1 (en) | 2013-02-14 |
EP2740420A1 (en) | 2014-06-11 |
EP2740420A4 (en) | 2015-04-08 |
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